Edna Watkins
Individual provider Active NPI Developmental Disabilities Clinic/Center · Mims, FL
NPI 1972159879 · NPPES record last updated Aug 15, 2019
Key facts
- NPI
- 1972159879
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Disabilities Clinic/Center 261QD1600X
- Practice address
- 2390 Mitchell Ave
Mims, FL 32754-4217 - Phone
- (321) 292-4818
- NPI assigned
- Aug 15, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Disabilities Clinic/Center | 261QD1600X | Yes |
Addresses
Primary practice location
2390 Mitchell Ave
Mims, FL 32754-4217
Mailing address
2390 Mitchell Ave
Mims, FL 32754-4217
Other providers in Mims, FL
All providers in Mims, FL · Developmental Disabilities Clinic/Center in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.